Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Mar;3(1):51-62.
doi: 10.1055/s-0032-1326950. Epub 2012 Oct 5.

Current status of adult spinal deformity

J A Youssef  1 , D O Orndorff  1 , C A Patty  1 , M A Scott  1 , H L Price  1 , L F Hamlin  1 , T L Williams  1 , J S Uribe  2 , V Deviren  3
Affiliations
Review

Current status of adult spinal deformity

J A Youssef et al. Global Spine J. 2013 Mar.

Abstract

Purpose To review the current literature for the nonoperative and operative treatment for adult spinal deformity. Recent Findings With more than 11 million baby boomers joining the population of over 60 years of age in the United States, the incidence of lumbar deformity is greatly increasing. Recent literature suggests that a lack of evidence exists to support the effectiveness of nonoperative treatment for adult scoliosis. In regards to operative treatment, current literature reports a varying range of improved clinical outcomes, curve correction, and complication rates. The extension of fusion to S1 compared with L5 and lower thoracic levels compared with L1 remains a highly controversial topic among literature. Summary Most adult deformity patients never seek nonoperative or operative treatment. Of the few that seek treatment, many can benefit from nonoperative treatment. However, in selected patients who have failed nonoperative treatment and who are candidates for surgical intervention, the literature reflects positive outcomes related to surgical intervention as compared with nonoperative treatment despite varying associated ranges in morbidity and mortality rates. If nonoperative therapy fails in addressing a patient's complaints, then an appropriate surgical procedure that relieves neural compression, corrects excessive sagittal or coronal imbalance, and results in a solidly fused, pain-free spine is warranted.

Keywords: coronal deformity; lumbar deformity; minimally invasive surgery; sagittal balance; surgical treatment.

PubMed Disclaimer

Conflict of interest statement

Disclosures C. A. Patty, None M. A. Scott, None H. L. Price, None L. F. Hamlin, None T. L. Williams, None V. Deviren, Consultant: NuVasive, Stryker, Medtronic, Guidepoint; Royalties: NuVasive; Fellowship Support: OREF, Omega, AOSpine J. S. Uribe, Consultant: NuVasive, Orthofix; Research Grant: NuVasive D. O. Orndorff, Paid Consultant: Integra, Stryker J. A. Youssef, Consultant: NuVasive, Integra; Royalties: NuVasive (potential conflict for an interbody device), Integra, Aesculap (potential conflict for an interbody device), Osprey Biomedical, Amedica (potential conflict for an interbody device); Research Support: DePuy, NuVasive, BioSurface Engineering Technologies, Globus Medical, Advanced Technologies in Regenerative Medicine, Axial Biotech; Ownership: ASC Durango; Stock/Options: Amedica, Pioneer, Vertiflex, Benvenue, Paradigm, Promethean Surgical Devices, ISD, Spinicity

Figures

Figure 1
Figure 1
A 38-year-old woman with scoliosis as demonstrated by anteroposterior (A) X-ray who underwent anterior instrumentation and fusion (B).
Figure 2
Figure 2
Patient with sagittal plane deformity (A, B) who had posterior only surgery with Ponte osteotomies (C, D) at 5-year follow-up.
Figure 3
Figure 3
Patient with progressive adult scoliosis. Anteroposterior (A) and lateral (B) X-rays obtained in 2004 demonstrate the progression compared with anteroposterior (C) and lateral (D) X-rays obtained in 2009. Postoperative anteroposterior (E) and lateral (F) X-rays demonstrate that the patient underwent a two-staged extreme lateral interbody fusion (XLIF) with posterior spinal fusion (PSF).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Birknes J K, White A P, Albert T J, Shaffrey C I, Harrop J S. Adult degenerative scoliosis: a review. Neurosurgery. 2008;63(3, Suppl):94–103. - PubMed
    1. Silva F E, Lenke L G. Adult degenerative scoliosis: evaluation and management. Neurosurg Focus. 2010;28:E1–E10. - PubMed
    1. Fu K M, Rhagavan P, Shaffrey C I, Chernavvsky D R, Smith J S. Prevalence, severity, and impact of foraminal and canal stenosis among adults with degenerative scoliosis. Neurosurgery. 2011;69:1181–1187. - PubMed
    1. Youssef J A, Hamlin L F. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2009. Adult spinal deformity; pp. 721–726.
    1. Vanderpool D W, James J I, Wynne-Davies R. Scoliosis in the elderly. J Bone Joint Surg Am. 1969;51:446–455. - PubMed